Page 35 - 21st Century Perspective - Glaucoma Supplement
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Glaucoma In a Nutshell
Definition: An enigmatic optic neuropathy characterized by progressive optic nerve head cupping
that is either caused by or moderated by intraocular pressure and various other factors such as age,
genetic predisposition, race, central corneal thickness, trauma and concurrent intraocular disease.
● Glaucoma is a common finding that is usually diagnosed during the course of routine eye
examinations.
● When detected early and treated properly, almost all patients remain asymptomatic for life.
● With the newer medicines, such as prostaglandins, alpha-adrenergic agonists, carbonic
anhydrase inhibitors and beta-blockers, IOP can usually be lowered to a pressure at which
further loss of optic nerve axons is halted or slowed sufficiently to keep the patient
asymptomatic.
Treatment: Reduce IOP to a safe level.
● Reduce aqueous humor production.
○ beta-adrenergic receptor antagonists (beta-blockers)
○ alpha-adrenergic receptor agonists (alpha agonists)
○ carbonic anhydrase inhibitors
● Enhance aqueous humor outflow.
○ prostaglandins (uveoscleral outflow)
○ pilocarpines (trabecular outflow)
■ Vyzulta works on both outflow pathways.
○ Netarsudil
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